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一项关于HLA抗体对肾移植存活影响的回顾性研究的18年随访

Eighteen-year follow-up of a retrospective study of HLA antibody on kidney graft survival.

作者信息

Lee P-C, Ozawa M, Hung C-J, Lin Y-J, Chang S-S, Chou T-C

机构信息

Medical College, National Cheng Kung University, Tainan, Taiwan.

出版信息

Transplant Proc. 2009 Jan-Feb;41(1):121-3. doi: 10.1016/j.transproceed.2008.10.078.

DOI:10.1016/j.transproceed.2008.10.078

PMID:19249493

Abstract

An increasing number of studies have demonstrated adverse graft survival in patients who have anti-HLA antibodies, whether preformed or developed posttransplantation. This retrospective study used Lambda antigen tray-mixed (LAT-M) screening and Luminex HLA class I and II specificity assay to re-examine the impact of pretransplantation HLA antibody on long-term graft survival. In this study, pretransplantation sera from 288 renal patients were tested using the enzyme-linked immunosorbent assay (ELISA) method, LAT-M. Among the 234 of the patients who did not have pretransplantation antibodies, 85% enjoyed 5-year functional graft survival, 76% 10-year functional graft survival, and 56% 15-year functional graft survival. The corresponding functional graft survival for the 54 patients who tested HLA antibody-positive was 65%, 53%, and 28%, respectively (P = .0021).

摘要

越来越多的研究表明，无论抗HLA抗体是移植前就存在的还是移植后产生的，有该抗体的患者移植器官的存活情况都较差。这项回顾性研究采用λ抗原板混合（LAT-M）筛查以及Luminex HLA I类和II类特异性检测方法，重新审视移植前HLA抗体对移植器官长期存活的影响。在本研究中，采用酶联免疫吸附测定（ELISA）方法、LAT-M对288例肾病患者的移植前血清进行检测。在234例移植前没有抗体的患者中，85%的患者移植器官在5年后仍有功能存活，76%在10年后仍有功能存活，56%在15年后仍有功能存活。检测HLA抗体呈阳性的54例患者移植器官的相应功能存活比例分别为65%、53%和28%（P = 0.0021）。